Malaria infects 300-500 million people each year, resulting in 1-3 million deaths and economic stagnation in endemic countries. Cerebral malaria (CM) is a severe manifestation of infection resulting in coma and death, and represents significant mortality. As with the placenta malaria model, much evidence supports parasite sequestration in host tissues as a key component in CM pathogenesis. This investigation will work to elucidate the parasite ligands responsible for mediating adherence to specific host receptors, and to correlate these parasite binding phenotypes with the clinical manifestations of disease. Microarray and tandem mass spectrometry assays will be performed on parasites extracted from the blood of patients in a longitudinal cohort study in Morogoro, Tanzania. The expression profiles from these assays will be correlated with the clinical presentation of the respective patients categorized with cerebral or non-cerebral malaria. The long term goal of this study is to define the parasite ligands associated with cerebral malaria so they might be targeted with intervention strategies.